Special precautions- Opiod tolereance and GI adverse reactions- patients exposed to opiods are more sensitive
to effects of mu-opiod receptors antagonists.
Because alvimopan acts pripherally clinicalsigns and symptoms of increased sensitivity
would be limited to GI tract eg abdominal pain, diarrhea, nausea and vomiting.
Administer avimopan 12mg capsules to these patients with caution
Bowel obstruction- use amimopan in patients undergoing surgery for correction of complete
bowel obstruction is not recommended
Renal function impairment- patients with mild to severe renal function impairment do not
require dosage adjustments, but closely monitor these patients for adverse reactions.
eg cramping, diarrhea, GI pain.
Hepatic function impairment - alvimpoan is not recommended for use in patients with severe
Pregnancy -use this drug during pregnancy only if clearly needed
Lactation- excercise caution when administering alvimopan to breast feeding women.
Children- safey and efficacy in children have not been established
Elderly- no dosage adjustment based on age is required on elderly patients
Dosages/ Overdosage Etc:
Post operative ileus
Dosage- Maximum dose - 12mg twice daily for no more than 15 doses
1. Inform patients that they must disclose long term or intermittant opoid pain therapy, including
any use of opiods in the week prior to receiving alvimopan
2. Inform them that the recent use of opiods may make them more susceptible to adverse
reactions of alvimopan
3. Inform patients that alvimopan is meant for hospital use only for more 7 days after bowel
4. Inform patients that most common adverse reactions with alvimopan in patients
undergoing bowel rescetion are constipation, dyspapsia and flatulence
Pregnancy and lactation:
Use this drug during pregnancy only if clearly needed
Excercise caution when administering alvimopan to breast feeding women.
Safey and efficacy in children have not been established
No dosage adjustment based on age is required on elderly patients
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